By September, Texas will run out of the sole drug it uses in lethal injections thanks in part to an overseas effort that has persuaded a European pharmaceutical company to halt its supply to U.S. states for use in executions.

The Texas Department of Criminal Justice announced last week that the state’s supply of pentobarbital — the sedative used in the lethal injections of its death-row inmates — would expire in September. Pentobarbital has become the most common drug in lethal injections in the U.S. Of the 23 executions this year, 22 of them used pentobarbital by itself or in combination with other drugs.

Texas is facing a depleted supply after a Danish drugmaker announced two years ago that it would no longer supply the drug for use in executions, thanks in part to pressure from multiple groups in Europe that have unexpectedly thrown up obstacles to U.S. states carrying out the death penalty.

In early 2011, Danish drugmaker Lundbeck, which at that time manufactured pentobarbital (sold under the name Nembutal), discovered that U.S. states were using its product in lethal injections. The complex international distribution networks of pharmaceuticals often make it difficult for manufacturers to know exactly where their products end up. But once pentobarbital’s use in U.S. executions came to light, many in Denmark were upset that medicine made in a country that abolished the death penalty decades ago was being used for ending lives rather than saving them.

By spring 2011, Danish newspapers were regularly publishing stories about pentobarbital’s use as several human-rights organizations, including Amnesty International and U.K.-based Reprieve, issued press releases to highlight each new execution that used drugs made by Lundbeck. In June 2011, Dr. David Nicholl — a neurologist and human-rights activist — wrote an open letter to Ulf Wiinberg, the chief executive of Lundbeck. The letter, signed by more than 60 other doctors and academics urging the company to halt its U.S. supply, was published in the medical journal the Lancet.

“As clinicians and prescribers of Lundbeck’s products, we are appalled at the inaction of Lundbeck to prevent the supply of their drug, Nembutal [pentobarbital], for use in executions in the USA,” the letter stated. “Pentobarbital is rapidly proving to be the drug of choice for U.S. executions. Lundbeck should restrict distribution of pentobarbital to legitimate users … but not to executioners.”

Three weeks later, Lundbeck said it would no longer allow the drug to be used in U.S. executions and began reviewing all orders of the drug and denying U.S. prisons looking to order it. Now, states like Texas, Georgia and Missouri are grappling with how to continue their planned executions without their go-to drug.

“When I first approached this issue, I thought it would never work,” says Nicholl, referring to the decision to apply pressure to drugmakers supplying states carrying out executions. “But our efforts have turned out to be quite effective. I don’t think the pharmaceutical companies realized the bad p.r. that it was going to lead them to.”

To halt its supply, Lundbeck worked with human-rights group Reprieve to simplify its distribution model, essentially taking out middlemen so the company could more easily identify who ended up with its products. Maya Foa, deputy director of Reprieve’s death-penalty team, says her organization’s goal isn’t to end capital punishment in the U.S. but merely to get pharmaceutical companies to follow the Hippocratic oath to do no harm.

“Their reason to be is to make medicine to save lives,” Foa says.

The struggle to obtain pentobarbital is the latest in a series of problems that have dogged lethal injection. In 2009, Hospira Inc., a drugmaker headquartered in Lake Forest, Ill., stopped making sodium thiopental, a general anesthetic often used in a three-drug method of lethal injection. That forced many states to look overseas, but both the U.K. and the E.U. blocked their own manufacturers from supplying it to the U.S. for executions.

The obstacles to getting sodium thiopental pushed states to rely even further on pentobarbital — but now it appears that states like Texas will once again have to find another drug to take its place. There are no generic versions of the drug, and the alternatives available have yet to be either tested or used in lethal injections.

John Hurt, the director of public information for the Texas Department of Criminal Justice, says the state is considering finding another supplier of pentobarbital, a different drug altogether or possibly working with a compounding pharmacy that could create the drug specifically for the state’s executions. (Texas, which has executed 503 inmates since 1982, more than any other state by far, has two executions scheduled in September, two more in October and one in November.)

It’s unclear where Texas would find another supplier. In December 2011, Lundbeck sold the rights to pentobarbital to Illinois-based Akorn Inc. The new company, however, signed an agreement saying it would follow the same distribution restrictions as Lundbeck.

Texas could turn to a compounding pharmacy, but according to the Death Penalty Information Center, those providers don’t face oversight from the Food and Drug Administration. That often leads to questions about the drugs’ safety and its intended effects of being a more humane alternative of execution.

“Compounding pharmacies are the underbelly of the industry,” says Maurie Levin, who has represented death-sentence inmates for 20 years, referring to a sector of the pharmaceutical industry that often goes under the radar of federal and state regulators.

Hurt says the most likely scenario is that Texas will simply find another drug to replace pentobarbital, and he cites Missouri’s intention to switch to the general anesthetic propofol, which gained notoriety when an overdose of the drug was blamed for singer Michael Jackson’s death. But last year, German drug manufacturer Fresenius Kabi announced last year that it too would no longer sell the drug to states for executions, shifting its distribution with help from Reprieve.

The best hope for states like Texas is that a domestic manufacturer would agree to make drugs like propofol or pentobarbital, far from a continent that has largely done away with the death penalty. But it should be no surprise that pharmaceutical companies aren’t racing to distribute drugs that are often associated more with death than life.

Correction: An earlier version of this story stated that Fresenius Kabi is the only supplier of propofol in the U.S. Hospira and Teva Pharmaceuticals restarted manufacturing and selling the drug earlier this year.

A complete justice system requires the death penalty for the worst crimes. Other effective means besides lethal injection exist for quickly executing the condemned: hanging, firing squad, and beheading. Yet, lethal injection brings a gentle death to the condemned. After losing consciousness due to the effect of an injected drug, the condemned never again feel anything.

I'm dying thanks to an inoperable brain tumor. I'm not permitted access to euthanasia and must undergo tortuous pain and countless other hellish symptoms. How is it that I can't legally end my suffering, but some states end the suffering that a life sentence would being to a criminal by executing them?

I've many times wondered the reasons for high prisoner population in America. The numbers seem comparable to the USSR gulags already.

'In The New Yorker article The Caging of America
(2012), Adam Gopnik writes "Over all, there are now more people under
“correctional supervision” in America—more than six million—than were in
the Gulag Archipelago under Stalin at its height."'

The drug companies have it right - using legitimate drugs for illegal reasons can not be condoned. The states are breaking the law to do so and they employ devious methods to circumvent the law in doing so These drugs were never meant to extinguish life which is what Texas and the other death penalty loving states wish to do- turn live prisoners into dead bodies - oh and do it cleanly so no one complains to loudly.

The fun part is watching the blood lust and revenge of the idiots screaming for hanging, electrocution and other torture methods like bullets and cutting off their heads show up here. You know people who want to elevate the conversation instead of joining the commonwealth of nations who have proved that the death penalty does not do anything except provide entertainment to the masses so they don't concentrate too much on how they are getting screwed by the `top one percent of their rulers.

Now you all go have fun with your toys and kill a few more minority prisoners - and keep going to your jobs and remember who you really work for ok. Bunch of idiots.

Next these criminal states will steal the drugs from vets - I mean you want to keep the show rolling along don't you? Of course you do you blood thirsty pigs. Can you just imagine if Rick Perry and Texas could not kill someone? Oh the shame and then what will people do for fun? Florida just killed a retarded man - how sporting - warehouse him for thirty years and take dumbo out one fine day and strap him to a slab and pump an overdose into him to kill him. Now does that not make you feel just warm and fuzzy inside - yup we know it does and it lowers you all to the level of filth too.

They should let them have a running start and then use some of their huge supply of guns and ammo to hunt him down publicly like a wild beast - hey then they can cut off his head and mount it on the wall like a trophy - what a great idea. They could decorate the game room in Perry's home with the heads of dead prisoners. Now that should be law - he has to star at them every day - now that makes sense. Taxidermy for dead prisoners - and a reminder to the guy who signs the death warrants - plus what a cool collection of memorabilia of official decisions.

Yes this is almost sick enough to satisfy the idiots who walk among us.

If Lundbeck is not going to sell Texas their pentobarbital, Texas will just have load their condemned inmates onto cargo planes and drop them 10,000 feet onto Lundbeck's headquarters in Copenhagen. See how these Danish moonbats like that.

If Europeans are so concerned let them take all of our death row prisoners and provide them with whatever more humane treatment they wish. As a matter of fact, let them take all of our deranged prison crud. Send our serial killers and child rapists to Paris, London, Berlin and the Vatican City and let those concerned Europeans take them all and care for them as they see fit. In the meantime, as far as our executions are concerned, we should just hang them.

How dare those Europeans butt their noses in Texas' business. If Texas says someone should be killed, then guilty or innocent, that person must die. Just ask cameron Todd Willingham or Carlos DeLuna. Being innocent didn't prevent Texas from killing them!

Capital punishment is such an odd topic. We are quibbling over not so much torture, but how comfortable someone is going to be as we kill them, how about a 50-cent bullet to the back of the head? According the the Supreme Court you can't execute an insane person because they can't appreciate what is happening to them, as if they are going to learn something from it. The only three things we know for sure is that some people are gratified to see evil people punished this way, we occasionally kill an innocent person and it takes years and millions to work its way through the courts for due process (which has ruined the theater of the event, like putting an animal down). It is just speculation whether it promotes or discourages crime.

Replace it with banishment, legally dead, no visitors except counsel, cut off from humanity to the extent Constitutionally possible and allow suicide. Quicker, cheaper, almost as odious and we can release a prisoner that was found to be innocent later.

I suggest using whatever method that the convicted did to kill his prey. If he drown someone, drown Him...If he shot someone, Shoot him... If he tortured someone, Torture him... If he cut off someone's penis, Cut off his penis...Don't worry about using a "Humane" method to put them to death, THEY certainly didn't use painless methods when they killed. Make them suffer. (And yes, I do believe in god)

That's fine... even if the Dutch need to mind their own bloody business. Texas can revert to the Chair, Hanging, Firing Squad... all methods that have been approved in the past. If they're too squeamish to take care of it, give me an email, I'll pull the lever/trigger in order to help humanity eliminate these viruses from the Global Gene Pool.

Using drugs to execute people... lame. If you want to kill someone, why choose one method over another? Diversify! Drown them, beat them with pipes, stick them in hydraulic presses, put them in wicker men... throw them from airplanes...

Unfortunately, running out of the drugs won't stop "eye for an eye" places like Texas from killing more of the alienated (mostly young & non-white) young men who fill our prisons. The states will just make up new rules and load up the syringes.

a sentence like " the best hope for a state like Texas " should belong in an article about supply shortage of the auto industry for example.

as a matter of fact, the whole article is written that way- I wonder where your humanity remains , as a writer for a magazine with such a high reputation you should try to treat such a sensitive subject accordingly.

"Mass incarceration on a scale almost unexampled in human history is a fundamental fact of our country today—perhaps the
fundamental fact, as slavery was the fundamental fact of 1850. In
truth, there are more black men in the grip of the criminal-justice
system—in prison, on probation, or on parole—than were in slavery then."

@rb1949 When all said and done, I doubt Texas buys a whole lot of the drug. From the sounds of it, the amount of negative publicity surrounding the drug as a result of human rights campaigns was incentive for them to stop sales to Texas. They're still motivated by sales, they just made the decision that the sale of 23 bottles per year to Texas to kill people wasn't enough to warrant all the bad publicity

Yeah...our exceptional country has guns....let's make sure we shoot Bambi's mom instead of another 20 kids....and a hearty salute to those European drug manufacturers who refuse to assist TX in killing more people.

@NemoNemoque I suggest a more elevated approach to the question of what to do with law breakers than mere punishment. It's no longer the Dark Ages and perhaps we are ready to try to "cure" those who commit crimes rather than "punish" them. Maybe a more enlightened state like Washington or Colorado should take the lead rather than relying on primitive states like Texas to set the agenda for what to do with the millions of Americans who have broken our often and unnecessary laws.

@anti-government@RobertVann Never has been! It's always been an employee of the system that pulled the lever, pulled the switch, or pushed the button to start the flow. And back when Texas was a republic they didn't even need that. There were always some good knot-tying citizens who would do it for free!